Healthcare Provider Details

I. General information

NPI: 1285961896
Provider Name (Legal Business Name): PATRICK GEORGE POPA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/03/2009
Last Update Date: 05/14/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 THE CITY DR S
ORANGE CA
92868
US

IV. Provider business mailing address

21260 BEACH BLVD APT. 208
HUNTINGTON BEACH CA
92648-5480
US

V. Phone/Fax

Practice location:
  • Phone: 714-456-5705
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberNONE YET
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberA117147
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: